My pathology report....

[davidn]

I go see a radiation doctor at Moffitt Cancer Center in Tampa on thursday, but I still want to go the surveillance route if possible. Here's the report

Left Testicle, Radical Orchiectomy:
Classic Seminoma (3.2 CM) with Satellite Nodule (1CM)
Negative for Capsular Invasion
Negative for Extratesticular Spread
Vascular Space Invasion Present
Negative Spermatic Cord Margin

Cancer Case Summary
Macroscope: left side
Locality: multifocal
Tumor Size: 3.2 cm plus 1 cm (satellite)
Histologic type: seminoma, classic type
AJCC staging: pT2 (vascular invasion) NX MX SX
Margins: uninvolved by tomur
Venous invasion: present

I was curious what vascular invasion means and also what venous invasion means. This is the first time I have seen my pathology report. After my surgery my urologist just told me it was Seminoma. That was all I knew. So when I picked up this report along with the slides today, I had to read it. Now I am anxious about what all of this means. I really don't want to do the radiation unless it is totally necessary. Any feedback from you guys would be awesome. Any questions about the report just ask. I'm going to go photocopy this before I give it to the Radiation doc. Thanks again
Dave

[Scott]

"Vascular invasion" and "venous invasion" mean that the tumor has grown into the lymphatic system and/or blood vessels, which increases the probability -- but does not guarantee -- that cancer has spread beyond the testicle.

[davidn]

with this vascular invasion, is the 70% cure rate from the orchieoctomy alone, still apply to me??

[Scott]

I'll have to see what else I can find, but here's a link to one report that quantifies the increased risk of recurrence due to vascular invasion.

[MRM]

Although I had nonseminoma, so my situation doesn't parallel with yours, your chance of cure, in general, is lower than the 80% if no invasion was present.

I didn't have the option of radiation, but everything I've read and most people who have posted here report it's not particularly bad-- far less side effects than chemo. Some people don't even miss more than a few hours of work the day they receive the treatment.

If I had had a seminoma, I would have gladly taken the radiation to boost my chance of cure to almost 100% immediately. I was less thrilled with the prospect of an RPLND that is often unnecessary.

If surveillance is an option for you, make sure you can handle the chance the cancer might come back. If you can't handle that uncertainty, get the radiation.

[davidn]

I went to see Dr. Javier Torres at Moffitt Cancer Center on Thursday. I was very surprised when he recommended surveillance. Since he is a radiation oncologist I thought for sure he would push for radiation. He told me there is still a 75% chance the surgery alone cured me, even with the vascular invasion. He said 10 years ago the standard treatment for stage 1 seminoma would of been radiation, but now more and more doctors are going the surveillance route due to the long term risk of radiation. I totally agree with him and I have my next cat scan in july. Thanks alot for letting me share with you guys....
Dave

[dadmo]

Just make sure you don't miss any of your follow-ups. Mark the dates on the calendar in this forum, on the one at home, and put it in your microsoft outlook.

[MRM]

My hospital is very good about sending letters reminding me about my next appointment and even calls the day before my CT to ensure I show up. Perhaps where you're being treated does something similar.

[mikeygti]

Although waiting for test results may be a bit worriesome,Surviellance sounds like a good option for you.

Chemotherapy is always there....just in case !

Best Wishes

[davidn]

i hear you. i can not miss any appointments and i won't. i'll keep y'all posted. thanks again for responding and i wish everyone here good health.
dave

[Don]

Hi Dave,

Was curious who did your surgery. I'm Also a patient of Moffitt.. They saved my life when nobodyelse could.. My surgeries were done by Dr. Pow-Sang and Dr. Wade --- My Onc is Dr. Mayer Fishman.. Which part of Florida are you from????? Hope all goes wel woth your next visit

[davidn]

Hey Don, my surgery was performed by Dr William Stafford at Mease Hospital. I live in Clearwater and he practices there. This was my first visit to Moffitt. I heard about it through this site, I think your posts. It seems like a great place and I really like Dr Torres. I wish you the best and if your ever in the Clearwater area we could get together.
Dave